Microsurgical Testicular Sperm Extraction (mTESE)

MicroTESE (mTESE) is an advanced way of harvesting sperm from a man struggling with infertility.

15% of couples will be diagnosed with infertility. In up to half of those cases there will a be a contributing male factor – that is why it is important to involve a urologist in your journey as a couple.

Many couples who have trouble conceiving naturally may be successful with IVF using ejaculated sperm, but in situations where there is a very low sperm count or no sperm at all, a surgical procedure may be required to harvest sperm.

Sperm can be harvested directly from the testicle or anywhere along the path from the testicle to the outside world via the vas deferens. Testicular biopsy, either using a needle or a formal surgical approach can be utilised, but sampling is often random and in situations of spermatogenic failure (difficulty producing sperm) a more sophisticated and targeted approach may be required.

A microTESE utilises a microscope to systematically search through testicular tissue to find the areas of best sperm production. Due to the precision of this technique, less testicular tissue is removed, and less trauma is caused to the testicle than can be seen with testicular biopsies. MicroTESE is successful in 40-60% of cases. Obviously these rates differ based on the individual patient’s condition, however given that more than half of the cases of male infertility are unexplained it is a reassuring figure.

The procedure is done as a day procedure under a general anaesthetic. A small incision is made in the midline of the scrotum. A specialised operating microscope is used to open and evaluate each testicle to give the best chance of finding sperm which can be used in IVF to father a child. Dissolvable sutures are used to close the wound and a small dressing is left in place for 2-5 days post operatively.